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Pokes and Pain: At a Glance

pokers_pain_glance

When treating your child’s bleeding condition, there are many ways they might show that they are in pain, even if they can’t say it. This chart, adapted from the Child Life Council’s Comfort Tips & Tricks Handout, can help you recognize when your child is in pain, offer distraction techniques, way to ease their anxiety, and proven comfort infusion positions complied by parents of children with a bleeding disorder.

If you would like to download and print this chart, click here.

Signs of Pain Distraction Techniques Comfort Positions for Pokes
Infants
(Use a combination of behaviors to signal pain. These signs may occur when the infant is not in pain, but combinations are usually present in an infant with pain.)
  • Irritable, restless
  • Whimpering
  • Crying continuously or intensely
  • Facial grimacing
  • Clenched fists
  • Keeping their body rigid
  • Refusing to eat
  • Unable to sleepIrritable, restless
  • Sugar solution for pacifier
  • Swaddling
  • Rocking in chair or other movement
  • Nursing or bottle-feeding
  • Interactive toys
  • Blowing bubbles
  • Light Wands
  • Singing
  • Ice pack or Buzzy tool
  • Family/Caregiver Lap
  • Nursing or bottle-feeding
  • Swaddled
Toddlers
  • Describe the pain
  • Cry
  • Show facial grimacing
  • Keep their body rigid, refuse to crawl or walk
  • Be more easily frustrated
  • Be aggressive
  • Be restless or unable to sleep
  • Interactive toys
  • Blowing bubbles
  • Light Wands
  • Singing
  • Ice pack or Buzzy tool
  • Family/Caregiver Lap
  • Hugging and hand-holding
  • Restraint may increase level of pain/anxiety
  • Avoid child laying on back – may increase anxiety
Preschool Children
  • Describe the pain
  • Show facial grimacing
  • Keep body rigid or refuse to move
  • Not want the area touched
  • Cry
  • Be restless or irritable
  • Have nightmares
  • Hesitate to admit pain if they view it as a punishment, or fear the treatment for it
  • Deep Breathing
  • Blowing Bubbles
  • TV/Video Games/Handheld Electronic Devices
  • Books
  • Counting
  • Singing
  • Ice pack or Buzzy tool
  • Family/Caregiver Lap
  • Hugging and hand-holding
  • Restraint may increase level of pain/anxiety
  • Avoid child laying on back – may increase anxiety
School Age Children
(Can talk more directly about the cause, type, and amount of pain.)
  • Holding still or guarding the area that hurts
  • Flat-faced expression
  • Facial grimacing
  • Emotional withdrawal
  • Irritability
  • Restlessness, thrashing
  • Disrupted sleep
  • Nightmares
  • Deep Breathing
  • TV/Video Games/Handheld Electronic Devices
  • Joke Telling/Conversation/ Counting
  • Rub/Stroke near infusion site
  • Ice pack or Buzzy tool
  • Sitting on a chair or parent lap
  • Hand-holding with a parent/ caregiver
  • Give the child some control – ask him/her what position they’d like best
Teens
(May show a combination of adult and childlike behavior.)
  • Change in activity level
  • Decreased cooperation
  • Change in eating or sleeping patterns
  • Irritability, restlessness
  • Anger or withdrawal
  • Deep Breathing
  • TV/Video Games/Handheld Electronic Devices
  • Music
  • Book
  • Ice pack or Buzzy tool
  • Offer choice of positions
  • Hand-holding with a parent if requested

 




Assisting and Advocating for the Bleeding Disorders Community